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An Informatics Infrastructure Is Essential for Evidence-based Practice

Affiliation of the author: Columbia University, New York, New York.

Correspondence and reprints: Suzanne Bakken, RN, DNSc, School of Nursing and Department of Medical Informatics, 630 W. 168th Street, New York, NY 10032; email: <suzanne.bakken{at}dmi.columbia.edu>.

The contention of the author is that an informatics infrastructure is essential for evidenced-based practice. Five building blocks of an informatics infrastructure for evidence-based practice are proposed: 1) standardized terminologies and structures, 2) digital sources of evidence, 3) standards that facilitate health care data exchange among heterogeneous systems, 4) informatics processes that support the acquisition and application of evidence to a specific clinical situation, and 5) informatics competencies. Selected examples illustrate how each of these building blocks supports the application of evidence to practice and the building of evidence from practice. Although a number of major challenges remain, medical informatics can provide solutions that have the potential to decrease unintended variation in practice and health care errors.

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